Does Guideline-Adherent Therapy Improve the Outcome for Early-Onset Breast Cancer Patients?Varga D.a · Wischnewsky M.b · Atassi Z.a · Wolters R.b · Geyer V.a · Strunz K.a · Kreienberg R.a · Woeckel A.a
aUniversitätsfrauenklinik Ulm, Ulm, und bZentrum für Angewandte Informationstechnologien, Universität Bremen, Bremen, Deutschland
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Background and Objective: Guidelines for the treatment of early-onset breast cancer have been proposed in several countries, but to date, their impact on outcomes is unverified. The objective of this study was to evaluate the association between guideline-adherent versus nonadherent treatment and recurrence-free survival (RFS) and overall survival (OAS) in early-onset breast cancer patients. Methods: A total of 1,778 patients were included in the study, of whom 111 were 35 years or younger and 1,667 were between 36 and 55 years. RFS and OAS were compared between the two groups, with respect to multiple parameters. All survival data were adjusted for tumor characteristics and analyzed with respect to guideline adherence according to the German Step 3 guidelines. Results: Statistically significant differences between the two groups (<35 years, 36–55 years) were observed with regard to breast surgery (p = 0.002) and hormone therapy (p = 0.006). Both groups were treated identically in terms of guideline adherence concerning axillary dissection (p = 0.9), radiation therapy (p = 0.7) and chemotherapy (p = 0.556). Young breast cancer patients whose treatment adhered to guideline recommendations had increased RFS and OAS [RFS: p = 0.030, hazard ratio (HR) 2.95, 95% confidence interval (CI) 1.11–7.83; OAS: p ≤ 0.001, HR 2.92, 95% CI 2.01–4.23]. Conclusion: Guideline-adherent treatment for early-onset breast cancer patients significantly improves OAS and RFS and should therefore be demanded for all patients.
© 2010 S. Karger AG, Basel
SEER Cancer Statistics Review, 1975–2005. Bethesda, National Cancer Institute, 2008.
- Maggard MA, O’Connell JB, Lane KE, Liu JH, Etzioni DA, Ko CY: Do young breast cancer patients have worse outcomes? J Surg Res 2003;113:109–113.
- Kim SH, Simkovich-Heerdt A, Tran KN, Maclean B, Borgen PI: Women 35 years of age or younger have higher locoregional relapse rates after undergoing breast conservation therapy. J Am Coll Surg 1998;187:1–8.
- Pritchard KI: Adjuvant therapy of the very young woman. Breast 2007;16(suppl 2):S136–S146.
- Figueiredo JC, Ennis M, Knight JA, McLaughlin JR, Hood N, et al: Influence of young age at diagnosis and family history of breast or ovarian cancer on breast cancer outcomes in a population-based cohort study. Breast Cancer Res Treat 2007;105:69–80.
- Ihemelandu CU, Leffall LD, Dewitty RL, Naab TJ, Mezghebe HM, et al: Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival. J Surg Res 2007;143:109–118.
- Rakha EA, Elsheikh SE, Aleskandarany MA, Habashi HO, Green AR, et al: Triple-negative breast cancer: distinguishing between basal and nonbasal subtypes. Clin Cancer Res 2009;15:2302–2310.
- Leconte I, Feger C, Galant C, Berlière M, Berg BV, et al: Mammography and subsequent whole-breast sonography of nonpalpable breast cancers: the importance of radiologic breast density. AJR Am J Roentgenol 2003;180:1675–1679.
Kreienberg R, for the German Cancer Society: Interdisziplinäre S 3-Leitlinie für die Diagnostik und Therapie des Mammakarzinoms der Frau. Munich, Zuckerschwendt Verlag, 2004.
- Schmidt M, Victor A, Bratzel D, Boehm D, Cotarelo C, et al: Long-term outcome prediction by clinicopathological risk classification algorithms in node-negative breast cancer – comparison between Adjuvant!, St Gallen, and a novel risk algorithm used in the prospective randomized Node-Negative-Breast Cancer-3 (NNBC-3) trial. Ann Oncol 2009;20:258–264.
Aryandono T, Harijadi, Soeripto: Breast cancer in young women: prognostic factors and clinicopathological features. Asian Pac J Cancer Prev 2006;7:451–454.
- Chung M, Chang HR, Bland KI, Wanebo HJ: Younger women with breast carcinoma have a poorer prognosis than older women. Cancer 1996;77:97–103.
Hadji P: Improving compliance and persistence to adjuvant tamoxifen and aromatase inhibitor therapy. Crit Rev Oncol Hematol 2009, E-pub ahead of print.
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